| 王晓燕,靳二虎.磁共振胆胰管成像显示"双管征"的意义[J].中国医学影像技术,2007,23(11):1666~1669 |
| 磁共振胆胰管成像显示"双管征"的意义 |
| Diagnostic value of morphological features of "double duct sign" at magnetic resonance cholangiopancreatography |
| 投稿时间：2007-07-12 修订日期：2007-09-20 |
| DOI： |
| 中文关键词: 双管征 壶腹周围癌 胰腺疾病 磁共振胆胰管成像 |
| 英文关键词:Double duct sign Periampullary carcinomas Pancreatic disease Magnetic resonance cholangiopancreatography |
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| 中文摘要: |
| 目的 探讨"双管征"在诊断壶腹周围癌及胰腺良恶性病变方面的价值。方法 对53例病人进行磁共振胆胰管成像(MRCP)检查并显示"双管征"。分析每一例病人的MRCP、轴位T1WI及T2WI,测量胆胰管汇合角度,十二指肠肠腔至胆胰管梗阻端的距离,胆胰管末端间距离,胆总管直径,胰管直径,观察胆总管末端形态,肝内胆管扩张程度,胰管形态,比较不同胰胆管疾病时"双管征"的差异。结果 在胰头癌和慢性胰腺炎组"双管征",胆胰管汇合角度、十二指肠腔至胆胰管狭窄段距离及胰管直径较非胰头壶腹周围癌组大,差异有显著意义。 "四节征"(13/27)和狭窄段侧支胰管扩张(6/27)多见于胰头癌。胰管粗细不均匀(9/10),边界不光滑,串珠状改变多见于慢性胰腺炎,这些征象与胰头癌组比较差异有显著意义(χ2=4.45,P<0.05)。3例(3/10)慢性胰腺炎伴有假囊肿,5例(5/10)伴有胰管结石。此外,与胰头癌组比较,慢性胰腺炎组的肝内胆管扩张较轻,胆总管末端以鼠尾状狭窄多见。结论 在MRCP图像识别"双管征"的不同表现有助于诊断和鉴别诊断良恶性胰胆管疾病。 |
| 英文摘要: |
| Objective To assess the value of the double duct sign at MRCP in the differential diagnosis of periampullary carcinomas and pancreatic disorders. Methods MRCP images of 53 patients proved by pathological result and clinical follow up were analyzed retrospectively. The cholangiopancreatic conjunction angles, the distances from the duodenal lumen to the ends of the dilated ducts, the distances between the ends of the double ducts, the diameters of the common bile duct and the pancreatic duct were measured. The shape of the distal ends of the bile duct, the shape of the pancreatic duct and the dilation extent of the intrahepatic bile duct were recorded. Results The cholangiopancreatic conjunction angles, the distances from the duodenal lumen to the ends of the dilated ducts, the diameters of the common bile duct and the pancreatic duct in pancreatic head carcinoma and chronic pancreatitis were lager than those of the periampullary carcinomas. The other characteristic appearances of pancreatic carcinomas were four-segment sign (13/27) and dilatation of the side branches of the main pancreatic duct around the stenotic segment (6/27). 90%(9/10) of pancreactic ducts in chronic pancreatitis were irregular (χ2=4.45, P<0.05). There were 3 (3/10) cases chronic pancreatis with paeudocyst and 5 (5/10) cases with calculus in the pancreactic ducts. Conclusion Double duct sign could be seen in benign and malignant pancreaticobiliary diseases. Correct identification of morphologic characteristics of diseased pancreatic and bile ducts was useful in the differential diagnosis of these disorders. |
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